Summary of medicine characteristics - ORALDENE
1 NAME OF THE MEDICINAL PRODUCT
ORALDENE
2. QUALITATIVE AND QUANTITATIVE COMPOSITION
ORALDENE contains 0.1% w/v hexetidine.
Excipients with known effect:
Ethanol (96%) 4.3 g per 100ml (4.33% w/v)
Azorubine (E122)
For the full list of excipients, see section 6.1
3 PHARMACEUTICAL FORM
4.1. Therapeutic indications
Shake well before use. Rinse the mouth, or gargle with at least 15 ml of undiluted solution, two to three times a day. Do not swallow the solution but spit out after use.
Children under 12 years Not recommended.
Method of administration For oromucosal use.
4.3 Contraindications
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
4.4. Special warnings and precautions for use
ORALDENE mouthwash is for external use only; the solution must therefore not be swallowed.
Excipients with known effect:
This medicine contains 623.5 mg of alcohol (ethanol) in each 15 ml. The amount in 15 ml of this medicine is equivalent to less than 16 ml beer or 7 ml wine. The small amount of alcohol in this medicine will not have any noticeable effects.
Azorubine (E122) may cause allergic reactions.
This medicine contains less than 1 mmol sodium (23 mg) per 15 ml, that is to say essentially ‘sodium-free’.
Not suitable for persistent symptoms.
4.5 Interaction with other medicinal products and other forms of interaction
No interactions are known.
4.6 Fertility, Pregnancy and lactation
No formal studies have been conducted in man. However, on the basis of animal studies and, in theory, the negligible systemic absorption it is considered highly unlikely that the use of ORALDENE during pregnancy will present a risk to the foetus.
It is not known whether hexetidine is excreted in human breast milk, however, in view of the negligible amount of hexetidine which could be predicted to be systemically absorbed, it is unlikely that concentrations of hexetidine in the milk will present any risk to the neonate/infant.
4.7 Effects on ability to drive and use machines
ORALDENE has no or negligible influence on the ability to drive and use machines.
4.8 Undesirable effects
ORALDENE is generally very well tolerated with a low potential for causing irritation, or sensitisation reactions. Prolonged use of ORALDENE is also well tolerated.
Patch testing with of hexetidine containing ointment was negative for irritation or sensitisation potential.
Adverse drug reactions (ADRs) identified during post-marketing experience with hexetidine are included in the tables below. The frequencies are provided according to the following convention:
Very common 1/10
Common 1/100 and <1/10
Uncommon 1/1,000 and <1/100
Rare 1/10,000 and <1/1,000
Very rare <1/10,000
Not known (cannot be estimated from the available data)
ADRs identified during post-marketing experience are presented by frequency category based on 1) incidence in adequately designed clinical trials or epidemiology studies, when available or 2) when incidence is unavailable, frequency category is listed as Not known.
Table 1 Adverse Drug Reactions Identified During Post-Marketing Experience with Hexetidine by Frequency Category Estimated from Clinical Trials or Epidemiology Studies:
Immune System Disorders
Not known Hypersensitivity reactions*;
Angioedema
Nervous System Disorders
Very rare Dysgeusia
Not known Ageusia
Respiratory, Thoracic and Mediastinal Disorders
Not known Cough; Dyspnoea**
Gastrointestinal Disorders
Not known Dry mouth; Dysphagia; Nausea;
Salivary gland enlargement;
Vomiting
General Disorders and Administration Site Conditions
Very rare Transient anaesthesia
Not known Application site reactions***
Inclusion of the PT of hypersensitivity reactions was based on cases reporting the following additional MedDRA PTs: Hypersensitivity and Urticaria.
* Observed in the context of Hypersensitivity.
* ** Inclusion of the PT of Application site reactions was based on cases reporting multiple MedDRA PTs. These included Mouth and Throat mucosa irritation, Paraesthesia oral, Tongue discolouration, Tooth discolouration, Inflammation, Blistering and Ulceration.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9 OverdoseSymptoms
Acute alcoholic intoxication is extremely unlikely, however, it is theoretically possible that, if a massive dose were swallowed by a small child, alcoholic intoxication may occur due to the ethanol content.
There is no evidence to suggest that repeated, excessive administration of hexetidine would lead to hypersensitivity-type reactions.
No adverse effects have been reported in overdose other than those seen in normal use.
Hexetidine, at the strength present in ORALDENE, is unlikely to be toxic when used as directed.
Ingestion of sufficient quantities of hexetidine in alcoholic solution may lead to signs/symptoms of alcohol intoxication.
Treatment of overdose is symptomatic, but rarely required. In the event of accidental ingestion of the contents of a bottle by a child, a doctor should be consulted immediately. Gastric lavage should be considered within two hours of ingestion and management should relate to treatment of alcoholic intoxication.
5 PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Antiinfectives and antiseptics for local oral treatment, ATC code: A01AB12
Hexetidine is a broad spectrum antimicrobial. It is active both in vivo and in vitro, against gram positive and negative bacterium, as well as yeasts (Candida albicans) and fungi.
5.2. Pharmacokinetic properties
Specific pharmacodynamic studies have not been carried out on ORALDENE in man.
The oral retention of hexetidine to mucous membranes and dental plaque has been observed. In studies using radiolabelled hexetidine it has been shown that retention on buccal tissues can extend to between 8 and 10 hours after a single oral rinse and in some cases hexetidine has been detected on oral tissues up to 65 hours post-treatment.
No absorption studies following the topical application of ORALDENE have been performed in man.
There have been no specific studies of ORALDENE or hexetidine in renal/hepatic impairment.
There have been no specific studies of ORALDENE or hexetidine in the elderly.
5.3. Preclinical safety data
5.3. Preclinical safety dataPre-clinical safety data do not add anything of further significance to the prescriber.
6 PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Polysorbate 80
Citric acid
Saccharin sodium
Levomenthol
Eucalyptus oil
Ethanol 96%
Azorubin (85%) (E122)
Sodium calcium edetate
Sodium hydroxide (E524)
Purified water
6.2. Incompatibilities
None.
6.3 Shelf life
2 years. 6 months after first opening.
6.4 Special precautions for storage
Do not store above 30°C. Keep the bottle in the outer carton in order to protect from light.
6.5 Nature and contents of container
6.6 Special precautions for disposal
McNeil Products Limited 50 – 100 Holmers Farm Way High Wycombe
Buckinghamshire
HP12 4EG
UK
8.